{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T18:20:37Z","timestamp":1790360437866,"version":"4.1.0"},"reference-count":36,"publisher":"Korean Association for the Study of Intestinal Diseases","issue":"2","license":[{"start":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:00:00Z","timestamp":1747180800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Takeda Pharmaceutical Company Limited"}],"content-domain":{"domain":["irjournal.org"],"crossmark-restriction":true},"short-container-title":["Intest Res"],"published-print":{"date-parts":[[2026,4,30]]},"abstract":"<jats:p>Background\/Aims: Patients with ulcerative colitis (UC) in remission commonly restrict thir lifestyle to prevent relapse; however, the effectiveness and impact on quality of life (QOL) is unclear. This study investigated whether lifestyle restrictions are associated with relapse reduction and assessed their impact on QOL. Methods: This multicenter, prospective cohort study was conducted in Japan (2018\u20132021) via the YOURS registry, enrolling patients with UC in clinical remission. Patients were followed for 2 years. A baseline questionnaire evaluated lifestyle restrictions in diet, work\/study\/housework, and physical exercise. QOL was assessed by Disease Impact Scale every 3 months during the first year of follow-up. Associations of lifestyle restrictions with relapse and QOL were assessed by Cox regression analysis and linear mixed-effects models, respectively. Results: Among 911 patients in clinical remission for &gt; 90 days, 63% had adopted dietary avoidance; 47%, work\/study\/housework avoidance; and 8%, physical exercise avoidance. Overall, 216 patients relapsed. Lifestyle restrictions were not associated with reduced risk of relapse (multivariableadjusted hazard ratios [95% confidence interval]: dietary avoidance, 1.08 [0.81\u20131.44]; and work\/study\/housework avoidance, 1.14 [0.87\u20131.50]); physical exercise avoidance was associated with increased relapse (multivariable-adjusted hazard ratio, 1.58; 95% confidence interval, 1.02\u20132.44). All lifestyle restrictions were associated with impaired QOL (P &lt;0.01). Conclusions: Lifestyle restrictions were not associated with relapse reduction in patients with UC; however, they were associated with impaired QOL. Clinicians should engage in evidence-based discussions with patients with UC in remission regarding lifestyle restrictions (UMIN Clinical Trials Registry; UMIN000031995).<\/jats:p>","DOI":"10.5217\/ir.2024.00199","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T02:10:26Z","timestamp":1747188626000},"page":"225-235","update-policy":"https:\/\/doi.org\/10.5217\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Lifestyle restrictions are associated with impaired quality of life but not reduction in relapse in ulcerative colitis"],"prefix":"10.5217","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9034-4370","authenticated-orcid":true,"given":"Hajime","family":"Yamazaki","sequence":"first","affiliation":[{"name":"Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan"},{"name":"Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5323-7058","authenticated-orcid":true,"given":"Masakazu","family":"Nagahori","sequence":"additional","affiliation":[{"name":"Clinical Research Center, Tokyo Medical and Dental University Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1178-3536","authenticated-orcid":true,"given":"Tadakazu","family":"Hisamatsu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2073-4234","authenticated-orcid":true,"given":"Taku","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute 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